Spontaneous external biliary fistula in a dog.
ABSTRACT A 10-year-old sexually intact female dog was examined because of a static, well-circumscribed subcutaneous mass and associated fistulous draining tract located along the right ventrolateral aspect of the thoracic body wall of 15 months' duration.
Results of computed tomography and fistulography confirmed the presence of the fistulous tract. Computed tomography also revealed a focal, hypodense region in the right ventral portion of the liver that was adjacent to but not clearly associated with the fistulous tract.
Surgical exploration of the tract revealed that it passed into the right hemithorax to the diaphragm; entered the right medial lobe of the liver; and terminated in a well-encapsulated, cystic liver lesion. The right medial liver lobe and all affected tissues were removed. Histologically, the liver lesion consisted of a fibrotic, dilated bile duct. The dilated bile duct and fistula were lined with biliary epithelium. On the basis of these findings, a diagnosis of spontaneous external biliary fistula was made. Five months after surgery, the dog was clinically normal.
To the authors' knowledge, spontaneous external biliary fistula in a dog has not been reported in the veterinary medical literature. Despite the rarity of this condition, it should be considered in a dog with similar clinical findings. Clinical findings and results of appropriate diagnostic imaging procedures may provide valuable information in making this diagnosis and in planning surgical treatment.
Article: Cholecystocutaneous fistula.International Journal of Dermatology 18(1):63-4. · 1.34 Impact Factor
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ABSTRACT: To determine long-term outcome of dogs with gallbladder mucocele. Retrospective study. 30 dogs with gallbladder mucocele, including 23 that underwent cholecystectomy. Medical records were reviewed for signalment, history, and clinical, ultrasonographic, and surgical findings. Follow-up information was obtained for all dogs that survived the perioperative hospitalization period. 23 dogs had signs of systemic illness; 7 had no clinical signs. Median values for serum activities of alanine aminotransferase and alkaline phosphatase, serum total bilirubin concentration, and total WBC count were significantly higher among dogs with gallbladder rupture than among dogs without rupture. Sensitivity of sonography for detection of rupture was 85.7%. Overall perioperative mortality rate for dogs that underwent cholecystectomy was 21.7%; mortality rate was not significantly greater for dogs with rupture. Aerobic bacteria were isolated from the bile or gallbladder wall in 8.7% of dogs. All 18 dogs discharged from the hospital had complete resolution of clinical signs. In dogs that underwent in-hospital reexamination, serum liver enzyme activities were significantly decreased, compared with preoperative activities. Persistent increases in serum activities of 1 or more liver enzymes were detected in 9 of 12 dogs; 6 of 12 dogs had persistent abnormalities in hepatic echogenicity. Mean follow-up period was 13.9 months. Results suggest that cholecystectomy is an effective treatment for gallbladder mucocele. Although perioperative mortality rate is high, prognosis after discharge from the hospital is excellent. Rupture of the gallbladder warrants emergency surgical intervention but does not preclude a positive outcome.Journal of the American Veterinary Medical Association 06/2004; 224(10):1615-22. · 1.72 Impact Factor
- Journal of Clinical Gastroenterology 02/2002; 34(1):99-100. · 3.20 Impact Factor